Lonely voices: A grounded theory study into the experiences of family members and mental health staff after suicide.

The way in which family members are supported by staff from the mental services after the suicide of a relative is an important, though not well researched area. This research aims to explore two main areas; firstly to explore from the family members perspectives how they were supported by staff after the suicide of their relative and whether this was what they would have wanted as a means of support. Secondly mental health staff were asked about what and how they provided support to families after the suicide of a relative and how they felt about what was provided by them and the service. This research project presents a qualitative study using grounded theory analysis of data collected from family members and mental health staff members about their experiences after the death from suicide of a family member or patient receiving care from the mental health services. The study sample comprised six staff and five family members who were interviewed face to face about what they experienced. The interviews were audiotaped and transcribed verbatim, then analysed in keeping with grounded theory, by using constant comparison of data, paying particular attention to reflexivity and researcher influence upon the data and on-going analysis. The core categories arising out of the analysis from the staff interviews showed that staff feel ill equipped to inform family members or provide support after their relative has died by suicide. More specifically the core categories presented the following key areas for staff as follows; 1. Training and awareness raising about suicide, including broadening understanding about the context within which suicide occurs. 2. The emotions involved with and related to the impact of suicide. 3. Skills and competence in breaking bad news to others including family members after suicide. 4. Including families in the care of people receiving mental health services. 5. Awareness and support with the formal processes that ensue following suicide. 6. Staff support after suicide, including managers, colleagues as well as staff in general in the organisation.
The core categories from the analysis of family members interviews showed, that; 1. Family members felt excluded and unheard by staff following the suicide of a relative. 2. Family members spoke about their fear for the future and the legacy of suicide. 3. The formal processes that take place after suicide were unclear and inconsistent for family members. 4. The emotional aftermath of suicide was significant however as core category 5 indicated, the family members experienced a mismatch between what they wanted and what they received from mental health staff and the organisation. Consequently core category 6. Showed how their experience motivated the family members to speak out and join the research into this subject. Conclusions are therefore set out with recommendations that promote guidance and training to mental health staff and services about ways to work with patients and families, incorporating current NHS policy, to improve staff skills and confidence; to ‘attune’ with patients and families, by including families in mental health care and afterwards if suicide happens, to which Family Therapy/systemic psychotherapy theory and practice could contribute in a variety of ways.